SYRACUSE, N.Y. -- If you twist your ankle at a Syracuse University Carrier Dome event, cut yourself or fall ill at a game, you can get emergency help from Upstate University Hospital doctors inside the dome's first aid station.

The station is on the lower concourse level just to the right of Gate B. Look for the big blue-green wall-wrap signs for Crouse Sports Medicine outside the room.

That's right, Crouse.

If you're confused who's doing the doctoring, thank sports marketing giant IMG. Tracing its beginnings to a handshake deal with Arnold Palmer in the 1960s, IMG has become the largest sports marketer in the world, generating more than $175 million a year for IMG and billions for its clients.

View full sizeFirst Aid station on the lower concourse floor of the Carrier Dome. Mike Greenlar | mgreenlar@syracuse.comMike Greenlar

In 2012 IMG swung the exclusive deal with Crouse, believed to be worth about $400,000 a year, to make Crouse the "Official Hospital of Syracuse University Athletics."

That designation gave Crouse exclusive hospital marketing privileges for all things related to SU sports, including advertising inside the dome. That means no Upstate hospital signs anywhere in the dome, even outside the first aid room to identify the Upstate doctors inside.

At knee level below splashy Crouse Hospital signage outside the first aid station is a small-print statement that doesn't clarify the situation: "First Aid Services provided by community EMS and other providers and not by Crouse Hospital."

Upstate doctors provide services only in the first aid room, under a contract between Upstate Emergency Medicine, Inc., a doctors group. Dr. Gary Johnson, president of Upstate Emergency Medicine, would not say how much the contract is worth or how long it is for. This summer at the New York State Fair, the doctor's group was paid $35,700 for 17 days of similar emergency services.

"I know some of the athletes who have been injured have been operated on by Upstate physicians," said Dr. John McCabe, CEO of Upstate Hospital.

Crouse and Upstate, which are physically connected by a pedestrian bridge, are fiercely competitive. Their battles sometimes play out in public.

Crouse had long been in merger talks with Community General Hospital until talks ended in May 2010. Upstate University Hospital stepped in and assumed ownership and operation of Community General Hospital in July 2011.

The IMG/Syracuse/Crouse exclusivity deal affects more than advertising in the dome.
Before the deal, Upstate could create an ad with Jim Boeheim, and refer to him as SU's men's basketball coach. No more. In any Upstate Hospital ads in which Boeheim appears, he can only be identified as Jim Boeheim. He can't be wearing a SU shirt, or holding a basketball with a SU emblem, or be seen in any environment connected to SU.

"In the past we had videoed at Manley Field House," said Melanie Rich, Upstate's former director of marketing, now retired. "After the contract (between IMG and Crouse) we had to shoot in a studio."

When the Crouse/IMG/SU deal was reached more than a year ago, it took Upstate officials by surprise.

"We were not asked or included in any of those discussions," said McCabe.

Through IMG, Syracuse University sports has grown immensely as a commercial enterprise, and its relation with sponsors like Upstate and Crouse hospitals has changed.

Exclusive sponsorship privileges command premium dollars. Crouse's three-year deal was struck in 2012. Emails between Upstate and IMG obtained through a freedom of information act request refer to a pending Crouse/IMG deal that would last five years and cost at least $400,000 a year.

Bob Allen, a vice president for Crouse, said the existing contract between Crouse and IMG is for three years and "not even in that vicinity." He would not say how much the contract cost Crouse.

"One of our strategic focus areas is the development of our sports medicine program," Allen said, and the contract aligns the Crouse brand with SU athletics.

Until 2012, at a dome event you could see advertising for any of Syracuse's hospitals - things like 30-second announcements about prostate cancer screening at Upstate. They would be shown on dome video boards before tip-off or at halftime during men's basketball games. But those cost a pittance - $19,000 for the 2011-2012 basketball season - compared to Crouse's exclusive contract.

"Exclusivity has boiled them (the number of sponsors) down and we've been able to get the value out of each category," said Joe Baldini, general manager of Syracuse IMG Sports Marketing, a branch of IMG Sports. "What it also does for us is it opens up new inventory that maybe we had tied up in four or five different clients."

IMG, together with a company it merged with, ISP, has been marketing SU sports since 1999.

IMG's multi-media rights contract with SU extends through the 2020-21 season, said Joe Giansante, SU's executive senior associate athletic director. Giansante would not say how much the contract is worth. But IMG sells everything from signage at the dome to the Time Warner logo on football coach Scott Shafer's headset.

IMG's payment to SU is a guaranteed amount, with a percentage of revenue shared once a threshold is met, he said.

IMG handles all of SU's marketing for football, men's and women's basketball and the coaches' radio show for those sports, as well as running men's lacrosse play-by-play radio and SU game programs. IMG handles all of SU sports' Internet rights, event marketing and game promotional rights, video rights, publication rights and all facilities signage rights.

IMG pays SU's top coaches a portion of their annual earnings, as reported in SU's tax statements, in exchange for their radio and television appearances. In the 2011-2012 school year, the most recent year for which records are available, IMG paid a total of $1.28 million to Jim Boeheim, Doug Marrone and SU's athletic director Daryl Gross. From IMG Boeheim received $600,000, or 33 percent of his $1.8 million earnings; Marrone received $618,940, or 60 percent of his $1.03 million earnings; Gross received $65,000, or 10 percent of his $653,710 earnings.

Inside the Carrier Dome, there's no shortage of potential ad space. Top dollar is demanded for ads in places that get the most TV exposure - the scorers' table, video boards, and the LED light band around the inside perimeter, said Baldini. Advertising also covers seat backs, tunnel entrances, even the wall space in the men's and women's restrooms.

Crouse has signage alongside scoreboards and above concourse tunnel entrances.
Crouse's "Official hospital of Syracuse University Athletics" slogan was announced in the fall of 2012, around the same time that the hospital announced a new sports medicine team and walk-in clinic for sport injuries. Crouse's sports medicine team includes Dr. Irving Raphael, head team doctor for Syracuse University athletics, and his son, Dr. Bradley Raphael, assistant team doctor for SU.

But for people walking into the dome's first aid station, it's doctors from Upstate's emergency department that will care for you.

"Nothing else has changed," said McCabe. "The same contract is in place, the same number of people show up and do exactly the same thing. We're just doing it in a place that's adorned with Crouse marketing materials."